Adjuvant chemotherapy prior to postoperative concurrent chemoradiotherapy for locoregionally advanced head and neck cancer

Kevin S. Choe, Joseph K. Salama, Kerstin M. Stenson, Elizabeth A. Blair, Mary Ellyn Witt, Ezra E W Cohen, Daniel J. Haraf, Everett E. Vokes

Research output: Contribution to journalArticle

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Abstract

Background and purpose: Induction chemotherapy prior to definitive concurrent chemoradiotherapy (CCRT) is a promising treatment option for unresectable head and neck cancer (HNC). In the postoperative setting, the efficacy of such an approach with adjuvant chemotherapy (AdjCT) followed by postoperative CCRT is unclear. Materials and methods: Forty-one postoperative patients with stage III-IV (M0) HNC enrolled on 3 consecutive phase II clinical trials were retrospectively analyzed. Twenty-five of the patients were treated on a protocol which included AdjCT with carboplatin and paclitaxel prior to postoperative CCRT (AdjCT group). Sixteen were treated on protocols with similar postoperative CCRT but without AdjCT (control group). CCRT consisted of paclitaxel, 5-fluorouracil, hydroxyurea, and twice-daily radiotherapy. Results: After a median follow-up of 72 months, there were no locoregional failures (LRF) or distant metastases (DM) in the AdjCT group. In the control group, there were 2 LRF and 2 DM. The 5-year risk of disease recurrence was 0% in the AdjCT group, compared to 28.9% in the control group (p = 0.0074). No patients had disease progression during AdjCT, and all proceeded to postoperative CCRT without delay. Conclusions: Adjuvant chemotherapy after surgery followed by CCRT may be a treatment strategy associated with favorable disease outcomes in locoregionally advanced HNC. These results pose a hypothesis which warrants further investigation.

Original languageEnglish (US)
Pages (from-to)318-321
Number of pages4
JournalRadiotherapy and Oncology
Volume97
Issue number2
DOIs
StatePublished - Nov 2010

Fingerprint

Chemoradiotherapy
Adjuvant Chemotherapy
Head and Neck Neoplasms
Paclitaxel
Control Groups
Neoplasm Metastasis
Phase II Clinical Trials
Induction Chemotherapy
Hydroxyurea
Carboplatin
Fluorouracil
Disease Progression
Radiotherapy
Recurrence
Therapeutics

Keywords

  • Chemoradiotherapy
  • Head and neck cancer
  • Induction chemotherapy
  • Postoperative radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Choe, K. S., Salama, J. K., Stenson, K. M., Blair, E. A., Witt, M. E., Cohen, E. E. W., ... Vokes, E. E. (2010). Adjuvant chemotherapy prior to postoperative concurrent chemoradiotherapy for locoregionally advanced head and neck cancer. Radiotherapy and Oncology, 97(2), 318-321. https://doi.org/10.1016/j.radonc.2010.09.003

Adjuvant chemotherapy prior to postoperative concurrent chemoradiotherapy for locoregionally advanced head and neck cancer. / Choe, Kevin S.; Salama, Joseph K.; Stenson, Kerstin M.; Blair, Elizabeth A.; Witt, Mary Ellyn; Cohen, Ezra E W; Haraf, Daniel J.; Vokes, Everett E.

In: Radiotherapy and Oncology, Vol. 97, No. 2, 11.2010, p. 318-321.

Research output: Contribution to journalArticle

Choe, KS, Salama, JK, Stenson, KM, Blair, EA, Witt, ME, Cohen, EEW, Haraf, DJ & Vokes, EE 2010, 'Adjuvant chemotherapy prior to postoperative concurrent chemoradiotherapy for locoregionally advanced head and neck cancer', Radiotherapy and Oncology, vol. 97, no. 2, pp. 318-321. https://doi.org/10.1016/j.radonc.2010.09.003
Choe, Kevin S. ; Salama, Joseph K. ; Stenson, Kerstin M. ; Blair, Elizabeth A. ; Witt, Mary Ellyn ; Cohen, Ezra E W ; Haraf, Daniel J. ; Vokes, Everett E. / Adjuvant chemotherapy prior to postoperative concurrent chemoradiotherapy for locoregionally advanced head and neck cancer. In: Radiotherapy and Oncology. 2010 ; Vol. 97, No. 2. pp. 318-321.
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abstract = "Background and purpose: Induction chemotherapy prior to definitive concurrent chemoradiotherapy (CCRT) is a promising treatment option for unresectable head and neck cancer (HNC). In the postoperative setting, the efficacy of such an approach with adjuvant chemotherapy (AdjCT) followed by postoperative CCRT is unclear. Materials and methods: Forty-one postoperative patients with stage III-IV (M0) HNC enrolled on 3 consecutive phase II clinical trials were retrospectively analyzed. Twenty-five of the patients were treated on a protocol which included AdjCT with carboplatin and paclitaxel prior to postoperative CCRT (AdjCT group). Sixteen were treated on protocols with similar postoperative CCRT but without AdjCT (control group). CCRT consisted of paclitaxel, 5-fluorouracil, hydroxyurea, and twice-daily radiotherapy. Results: After a median follow-up of 72 months, there were no locoregional failures (LRF) or distant metastases (DM) in the AdjCT group. In the control group, there were 2 LRF and 2 DM. The 5-year risk of disease recurrence was 0{\%} in the AdjCT group, compared to 28.9{\%} in the control group (p = 0.0074). No patients had disease progression during AdjCT, and all proceeded to postoperative CCRT without delay. Conclusions: Adjuvant chemotherapy after surgery followed by CCRT may be a treatment strategy associated with favorable disease outcomes in locoregionally advanced HNC. These results pose a hypothesis which warrants further investigation.",
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AU - Witt, Mary Ellyn

AU - Cohen, Ezra E W

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